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em@3am

EM@3AM: Suppurative Parotitis

A 75-year-old male presents to the ED with right facial swelling since last night. He is also complaining of pain and subjective fevers. Initial vital signs include BP of 150/85, HR 103, T 100.8, RR 18, SpO2 97% on RA. Exam reveals the patient to be ill-appearing with a focal area of swelling medially to his right ear that is warm and tender to palpation. His oral mucosa is dry. He has multiple dental caries and poor dentition overall. Massage of the area of swelling reveals purulent drainage from the oral mucosa near the right maxillary molars.  What is the most likely diagnosis?